MEDICARE: VALLEY SLEEP PHYSICIANS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RS0012X	Sleep Medicine (Internal Medicine) Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265874630
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY SLEEP PHYSICIANS, INC

Provider Business Mailing Address
First Line	:	PO BOX 30388
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85275-0388
Country	:	US
Telephone Number	:	480-361-0110
Fax Number	:	480-830-3901

Provider Business Practice Location Address
First Line	:	4555 E INVERNESS AVE STE 112
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-4630
Country	:	US
Telephone Number	:	480-361-0110
Fax Number	:	480-830-3901

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LAURI LYNN LEADLEY
Credential	:
Telephone Number	:	602-300-9158

Provider Enumeration Date	:	07/25/2013
Last Update Date	:	10/26/2021

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